Effect of expedited treatment of sex partners on recurrent or persistent gonorrhea or chlamydial infection
Effect of expedited treatment of sex partners on recurrent or persistent gonorrhea or chlamydial infection
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DOI：
10.1056/nejmoa041681
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发表时间：
2005-02-17
影响因子：
158.5
通讯作者：
Holmes, KK
中科院分区：
文献类型：
--
作者：
Golden, MR;Whittington, WLH;Holmes, KK
背景：许多淋病或衣原体感染者的性伴侣没有接受治疗，这导致频繁的再感染和进一步的transmission.METHODS：我们随机分配淋病或衣原体感染的女性和异性恋男性，让他们的伴侣接受加速治疗或标准转诊。加速治疗组的患者被提供药物给他们的性伴侣，或者如果他们愿意，研究工作人员联系他们的性伴侣并在没有临床检查的情况下为他们提供药物。被分配到标准伴侣转诊的患者被建议转诊其伴侣接受治疗，并提供援助通知伴侣。主要结果是持续性或复发性淋病或衣原体感染的患者3至19 weeks aftertreatment.Results：持续性或复发性淋病或衣原体感染发生在121/931（13%）分配到标准的合作伙伴转诊和92/929（10%）分配到加速治疗的性伙伴（相对风险，0.76; 95%的置信区间，0.59至0.98）。在减少淋病患者的持续或复发感染方面，加速治疗比伴侣的标准转诊更有效（3%对11%，P=0.01）（11%对13%，P=0.17）（治疗效果比较P=0.05）在对其他感染预测因素进行调整后，（相对风险，0.75; 95%置信区间，0.57至0.97）。分配到加速治疗的性伴侣的患者比那些分配到标准转诊的合作伙伴，更有可能报告说，他们的合作伙伴进行了治疗，并显着不太可能报告与未经治疗的partner.CONCLUSIONS：加速治疗的性伴侣降低持续性或复发性淋病或衣原体感染的发病率。
BACKGROUND:Many sex partners of persons with gonorrhea or chlamydial infections are not treated, which leads to frequent reinfections and further transmission.METHODS:We randomly assigned women and heterosexual men with gonorrhea or chlamydial infection to have their partners receive expedited treatment or standard referral. Patients in the expedited-treatment group were offered medication to give to their sex partners, or if they preferred, study staff members contacted partners and provided them with medication without a clinical examination. Patients assigned to standard partner referral were advised to refer their partners for treatment and were offered assistance notifying partners. The primary outcome was persistent or recurrent gonorrhea or chlamydial infection in patients 3 to 19 weeks after treatment.RESULTS:Persistent or recurrent gonorrhea or chlamydial infection occurred in 121 of 931 patients (13 percent) assigned to standard partner referral and 92 of 929 (10 percent) assigned to expedited treatment of sexual partners (relative risk, 0.76; 95 percent confidence interval, 0.59 to 0.98). Expedited treatment was more effective than standard referral of partners in reducing persistent or recurrent infection among patients with gonorrhea (3 percent vs. 11 percent, P=0.01) than in those with chlamydial infection (11 percent vs. 13 percent, P=0.17) (P=0.05 for the comparison of treatment effects) and remained independently associated with a reduced risk of persistent or recurrent infection after adjustment for other predictors of infection at follow-up (relative risk, 0.75; 95 percent confidence interval, 0.57 to 0.97). Patients assigned to expedited treatment of sexual partners were significantly more likely than those assigned to standard referral of partners to report that all of their partners were treated and significantly less likely to report having sex with an untreated partner.CONCLUSIONS:Expedited treatment of sex partners reduces the rates of persistent or recurrent gonorrhea or chlamydial infection.